GOTTLIEB MEMORIAL HOSPITAL (NPI# 1366555245) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1366555245 |
Entity Type | Organization |
Organization Name | GOTTLIEB MEMORIAL HOSPITAL |
Other Organization Name | GOTTLIEB MEMORIAL HOSPITAL TCU |
Practice Address |
701 W North Ave Melrose Park IL 60160-1612 |
Practice Telephone | 7086813200 |
Practice Fax Number | 7084505058 |
Mailing Telephone | 7086813200 |
Mailing Fax Number | 7084505058 |
Enumeration Date | 2006-08-16 |
Last Update Date | 2011-10-19 |
Authorized Official Name | MRS. ELLYN CHIN (VICE PRESIDENT OF FINANCE) |
Authorized Official Telephone | 7086813200 |
Is Organization Subpart | Y |
Parent Organization Name | GOTTLIEB MEMORIAL HOSPITAL |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 314000000X | Skilled Nursing Facility | 0005561 | IL | Nursing & Custodial Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IL | BLUE CROSS | 0741 | 01 |
Other Name | Type Code |
---|---|
GOTTLIEB MEMORIAL HOSPITAL TCU | Other Name - Individual/Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1518070499 | Gottlieb Memorial Hospital | Home Health | 905 West North Avenue, Melrose Park, IL 60160-1602 | 2006-08-16 |
1831170232 | Gottlieb Memorial Hospital | General Acute Care Hospital | 701 W North Ave, Melrose Park, IL 60160-1612 | 2005-11-11 |
1063967958 | Gottlieb Memorial Hospital | Clinic/Center | 701 W North Ave, Melrose Park, IL 60160-1612 | 2016-08-20 |
1396109500 | Gottlieb Memorial Hospital | Rehabilitation Unit | 701 W North Ave, Melrose Park, IL 60160-1612 | 2016-04-13 |
1659473718 | Gottlieb Memorial Hospital | Durable Medical Equipment & Medical Supplies | 675 W North Ave, Melrose Park, IL 60160-1634 | 2006-09-01 |
1639271794 | Gottlieb Memorial Hospital | Psychiatric Unit | 701 W North Ave, Melrose Park, IL 60160-1612 | 2006-09-01 |
1790898674 | Gottlieb Memorial Hospital | Dietitian, Registered | 701 W North Ave, Melrose Park, IL 60160-1612 | 2006-08-16 |
1225141104 | Gottlieb Memorial Hospital | Hospice Care, Community Based | 701 West North Avenue, Melrose Park, IL 60160-1602 | 2006-08-16 |
Street Address |
701 W NORTH AVE |
City | MELROSE PARK |
State | IL |
Zip Code | 60160-1612 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1831170232 | Gottlieb Memorial Hospital | General Acute Care Hospital | 701 W North Ave, Melrose Park, IL 60160-1612 | 2005-11-11 |
1447889092 | Gottlieb Emergency Physicians LLC | Emergency Medicine | 701 W North Ave, Melrose Park, IL 60160-1612 | 2020-04-06 |
1851930283 | Brian Joseph Iacopelli | Nurse Anesthetist, Certified Registered | 701 W North Ave, Melrose Park, IL 60160-1612 | 2020-01-02 |
1164061594 | Jonathan Bickmann | Registered Nurse | 701 W North Ave, Melrose Park, IL 60160-1612 | 2020-01-02 |
1952940306 | Cory Daniel Ott | Nurse Anesthetist, Certified Registered | 701 W North Ave, Melrose Park, IL 60160-1699 | 2020-01-02 |
1790324226 | Andrew Reichard | Nurse Anesthetist, Certified Registered | 701 W North Ave, Melrose Park, IL 60160-1612 | 2020-01-01 |
1235778200 | Ryan Mcguire | Occupational Therapist | 701 W North Ave, Melrose Park, IL 60160-1612 | 2019-12-23 |
1053962340 | Fabiola Adriana Nava-lopez | Nurse Practitioner | 701 W North Ave, Melrose Park, IL 60160-1699 | 2019-09-27 |
1114581741 | Julie Bartoski | Occupational Therapist | 701 W North Ave, Melrose Park, IL 60160 | 2019-04-29 |
1831660448 | Michael J Sit | Registered Nurse | 701 W North Ave, Melrose Park, IL 60160-1699 | 2018-12-07 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1295217651 | Kairsten Thies | Registered Nurse | 1225 W. Lake St., Melrose Park, IL 60160 | 2018-09-02 |
1780195701 | Julia Mccann-khludenev | Nurse Practitioner | 153 1/2 Broadway Ave., Melrose Park, IL 60160 | 2017-10-17 |
1629595749 | Katarzyna Teresa Buksa | Speech-Language Pathologist | 906 Walton St., Melrose Park, IL 60160 | 2017-08-29 |
1972955102 | Erika Lazaro | Counselor | 1414 Main Street, Melrose Park, IL 60160 | 2016-07-12 |
1811344096 | Margaret Ann Kress | Nurse Practitioner | 675 W North Ave Ste 402, Melrose Park, IL 60160 | 2016-05-18 |
1942578703 | Rachna Shah Md Sc | Internal Medicine | 675 West North Ave, #310, Melrose Park, IL 60160 | 2011-12-08 |
1033486741 | Stephanie Lamonica | Pharmacist | 850 West North Ave, T0837, Melrose Park, IL 60160 | 2011-11-23 |
1285913384 | Melinda Vazquez | Social Worker | 1414 Main, Melrose Park, IL 60160 | 2011-08-08 |
1629373212 | Advanced Wellness Clinics | Internal Medicine | 1835 N Broadway Avenue, Suite 104, Melrose Park, IL 60160 | 2011-01-13 |
1508188525 | Guillermo Fernando Mora | Family Medicine | 1111 W Superior, Suite #306, Melrose Park, IL 60160 | 2010-02-17 |
Find all providers in zip 60160 |
Taxonomy Code | 314000000X |
Grouping | Nursing & Custodial Care Facilities |
Classification | Skilled Nursing Facility |
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
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City | MELROSE PARK |
Zip Code | 60160 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.